title: Increase in sudden death from coronary artery disease in young adults.
abstract: BACKGROUND
  Sudden cardiac death (SCD) is the most common cause of death in adults aged <65 years, making it a major public health problem. A growing incidence in coronary artery disease (CAD) in young individuals has been predicted in developed countries, which could in turn be associated with an increase in SCD in this population. The aim of the study was to assess the prevalence of CAD among autopsies of young individuals (<40 years) who had sudden death (SD).
  
  
  METHODS
  We selected all the autopsies referred to the Montreal Heart Institute and Maisonneuve-Rosemont Hospital from January 2002 to December 2006 that corresponded to individuals <40 years old who had died suddenly. For each decedent, the following data were collected: cause of death, autopsy findings, available clinical history, toxicological findings, and cardiovascular risk factors.
  
  
  RESULTS
  From a total of 1,260 autopsies, 243 fulfilled the inclusion criteria. Coronary artery disease was the main cause of SCD from age 20 years, representing the 37% of deaths in the group of 21 to 30 years old, and up to 80% of deaths in the group of 31 to 40 years old. Among individuals who died of CAD, 3-vessel disease was observed in 39.7% of cases. Moreover, among the whole population <40 years old, at least 1 significant coronary lesion was observed in 39.5% of cases, irrespective to the cause of death. In the multivariable analysis, an increased BMI (hazard ratio 1.1 for each kg/m(2), 95% CI 1.01-1.1) and hypercholesterolemia (hazard ratio 2.4, 95% CI 1.7-333.3) showed to be the modifiable factors related to an increased risk of SD from CAD.
  
  
  CONCLUSIONS
  In our population, CAD was the main cause of SD from age 20 years. These data bring into question whether present prevention strategies are sufficient and reinforce the need to extend prevention to younger ages.
authors.affiliation: Montreal Heart Institute, University of Montreal, Canada.
authors.forename: Dabit
authors.initials: D
authors.lastname: Arzamendi
authors.forename: Begoña
authors.initials: B
authors.lastname: Benito
authors.forename: Helena
authors.initials: H
authors.lastname: Tizon-Marcos
authors.forename: Jose
authors.initials: J
authors.lastname: Flores
authors.forename: Jean François
authors.initials: JF
authors.lastname: Tanguay
authors.forename: Hung
authors.initials: H
authors.lastname: Ly
authors.forename: Serge
authors.initials: S
authors.lastname: Doucet
authors.forename: Louis
authors.initials: L
authors.lastname: Leduc
authors.forename: Tack Ki
authors.initials: TK
authors.lastname: Leung
authors.forename: Oscar
authors.initials: O
authors.lastname: Campuzano
authors.forename: Anna
authors.initials: A
authors.lastname: Iglesias
authors.forename: Mario
authors.initials: M
authors.lastname: Talajic
authors.forename: Ramon
authors.initials: R
authors.lastname: Brugada
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000401:mortality; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000401:mortality*; D003645:Death, Sudden / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult